Doctors say 84 patients who have had infections have died at Burnaby General Hospital since 2009.Ian Lindsay
/ PNG Files

Eight senior physicians are ringing alarm bells about the risk of contracting C difficile at Burnaby General Hospital, saying 84 patients have died there as a result of the infection within two and a half years.Handout
/ ...

Related

METRO VANCOUVER -- Fraser Health will hire a senior medical director to help reduce rates of infection across all its hospitals, president and CEO Dr. Nigel Murray announced Friday afternoon, adding the immediate focus of the new position will be on continuing to rein in high rates of C. difficile at Burnaby General Hospital.

“We must take immediate steps to restore confidence in infection prevention and control practices,” Murray told reporters in a conference call.

“The purpose of this is to ensure that we have continuous improvement in infection rates, and to ensure that such practices are consistent with national and international standards for infection prevention and control,” he added.

Murray said Fraser Health has not yet identified a candidate for the new position, adding it will conduct an intensive search to find the right person for the job.

Murray’s announcement came at the end of a difficult week for Fraser Health, one where its infection-control practices have been put under a public microscope.

On Wednesday, a letter from eight senior doctors surfaced revealing serious concerns over the fact that 84 patients with C. difficile had died at Burnaby General Hospital between 2009 and mid-2011. Rates of the infection at the hospital have ranged between two to three times the national average, the doctors said.

An external review conducted at the request of Fraser Health, and released this week, also showed the organization’s regional infection-control program “does not meet any modern staffing recommendations.”

On Friday, Murray gave his personal commitment this will be rectified, and that Fraser Health will enact all of the recommendations made in the external review by Dr. Michael Gardam. On Thursday officials at Fraser Health said they were working to immediately implement 10 of the 13 recommendations in the report.

Dr. Shane Kirby, the chair of the Burnaby Hospital infection-control committee who was the top signatory on the initial doctors’ letter, said the new position Murray announced Friday is a “good, positive start.”

“It’s good to hear,” he said in an interview, adding he did not know any details of the announcement.

In the Jan. 9 letter, Kirby and the other seven senior doctors drew attention to the fact that Fraser Health’s regional medical director of infection control was a part-time position staffed by someone who had expressed a desire to retire in 2012. The doctors added their concern that Fraser Health had not identified a successor to take over the crucial position.

On Friday, Fraser Health officials said the new position announced by Murray comes in addition to the medical director referred to by doctors in their letter. The position described by Murray is a “new, more senior position to enhance physician leadership and support for all our hospitals and community services,” Fraser Health said.

“We already do have experts here in Fraser Health, but we want to enhance that and that will be something that I would personally like to consult with some of the physicians that have raised this issue with us, and others, to make sure the nature and function of the role can meet everyone’s expectation,” Murray said Friday.

“This role will report to our senior executive, but also will have direct access to the board of Fraser Health.”

Also Friday, Kirby released a letter he sent on Thursday to Murray, expressing his disappointment at the little progress that had been made so far.

“The measures to date for control of [C. difficile] at Burnaby Hospital have been and are frankly insufficient,” he wrote, adding the situation at the hospital has improved only marginally, going from “horrific to horrible.”

“There is significant discrepancy between the understanding of yourself and the Fraser Health Authority Executive and the reality of what is actually taking place on the ground in terms of Infection Control Practice,” Kirby wrote.

“Such is the degree of concern, I question whether the scope of these problems needs to be brought directly to the attention of the Minister of Health for British Columbia.”

In his letter Thursday, Kirby called for immediate action.

“It is my sincere hope that the subsequent actions of yourself and the senior administration within the Fraser Health Authority will not be limited to “spin control,” but will instead represent meaningful re-evaluation and correction of these extensive problems,” he wrote.

Among his recommendations, Kirby called for autopsies to be conducted on all future deaths in the hospital where a patient is suspected to have C. difficile.

Murray told reporters Fraser Health has “made significant inroads into reducing infection rates at Burnaby General from 2009 to today by 40 per cent.

“I wouldn’t characterize that as horrible,” he said, agreeing, however, “we’ve got a long way to go.”

Health Minister Mike de Jong could not be reached for comment Friday, but his office issued a statement on his behalf.

“I will meet personally with the health authority and the physicians who have expressed concerns at Burnaby General Hospital at the earliest possible opportunity,” said the statement. “These are serious issues and I will continue to monitor these efforts closely along with ministry staff to ensure the health authority is doing everything possible to provide high quality patient care.”

The Hospital Employees’ Union has also raised questions about the usefulness of cleaning audits at B.C. hospitals. Burnaby General surpassed the benchmark cleaning standard set by the province over the time period doctors say the bulk of the C. difficile deaths were occurring, according to a report from Westech Systems Inc., the independent auditor contracted by the province to conduct the monthly inspections in the Lower Mainland.

Auditors gave Burnaby General an overall score of 91.95 per cent after conducting 127 audits between August 2009 and March 31, 2010. The provincial benchmark is 85 per cent.

This led the Health Employees’ Union to charge that the audits do not give a complete picture of hospital cleanliness. The auditors fail to investigate issues critical to infection control such as the intensity and frequency of cleaning, the training of cleaners, the workload of cleaners, and the adequacy of cleaning supplies and equipment, the union said in a news release Thursday.

The Fraser Health Authority contracted out cleaning services to a private company in 2003.

But Westech president Dean Waisman noted that many factors critical to infection control are not detectable by cleaning auditors. Hand sanitizing is crucial as C. difficile infection spreads when someone touches a surface contaminated with the bacteria and then touches their mouth without washing their hands. And because C. difficile bacteria live in the stool of the infected person, hospital overcrowding — leading to situations in which four or more people are sharing a bathroom — are also a big risk factor, Waisman said.

Another factor that contributes to the spread of C. difficile is antibiotic resistance, Waisman said.

On Friday, Murray acknowledged that over-prescription of antibiotics by doctors, which can lead to resistance in some patients, is a problem in the Fraser Health region and around the world.

“From time to time we find situations where patients may have been on antibiotics too long and that can affect the bacteria in the intestine or colon that allows this infection to take place,” he said. “The issue can be that we use them excessively and sometimes we just need to work with physicians to change prescribing habits.”

To conduct cleaning audits, inspectors go into rooms armed with powerful flashlights, extendable mirrors and baby wipes, Waisman explained. There are 19 different inspection categories, such as floors and beds. Devices that patients touch frequently, such as tray tables, have a higher threshold for passing the inspections, Waisman said.

“We’re actually using the flashlight on surfaces. We get underneath over-bed tables. We’re wiping surfaces that to the eye look clean, but you take a wet-wipe to it and it can come out dark from the residue on those surfaces.”

The inspections are weighted so that more scrutiny is given to high-risk areas such as operating rooms and emergency rooms, Waisman said. He also emphasized that the hospital scores in the report are averaged over half a year and month-to-month scores vary quite a bit.

Westech will be rolling out a new inspection technique over the next couple of months under which inspectors will sprinkle invisible powder on a surface, then come back in 24 hours with a ultraviolet light to see if the powder is still visible.

Comments

We encourage all readers to share their views on our articles and blog posts. We are committed to maintaining a lively but civil forum for discussion, so we ask you to avoid personal attacks, and please keep your comments relevant and respectful. If you encounter a comment that is abusive, click the "X" in the upper right corner of the comment box to report spam or abuse. We are using Facebook commenting. Visit our FAQ page for more information.

Video

Health Videos

Best of Postmedia

Be afraid. Be very afraid. Ignore the diversions in the United States: athletes kneeling or standing during the national anthem; Republicans flailing and failing again on health care; a kick-boxing creationist possibly becoming senator from Alabama. Calamity looms elsewhere. We are hurtling toward war with North Korea. It may be as early as next month. […]

It wasn’t in the middle of a farmer’s muddy field or deep in the boreal forest where the Canadian oilsands truly struck pay dirt. It was inside Fort McMurray’s recreation centre. More than 1,400 oilpatch workers, corporate executives, provincial leaders and the country’s prime minister assembled 21 years ago in northern Alberta to grasp a […]

Google’s powerful search engine is defeating some court-ordered publication bans in Canada and undermining efforts to protect young offenders and victims. Computer experts believe it’s an unintended, “mind-boggling” consequence of Google search algorithms. In six high-profile cases documented by the Citizen, searching the name of a young offender or victim online pointed to media coverage […]

Almost Done!

Postmedia wants to improve your reading experience as well as share the best deals and promotions from our advertisers with you. The information below will be used to optimize the content and make ads across the network more relevant to you. You can always change the information you share with us by editing your profile.

By clicking "Create Account", I hearby grant permission to Postmedia to use my account information to create my account.

I also accept and agree to be bound by Postmedia's Terms and Conditions with respect to my use of the Site and I have read and understand Postmedia's Privacy Statement. I consent to the collection, use, maintenance, and disclosure of my information in accordance with the Postmedia's Privacy Policy.

Postmedia wants to improve your reading experience as well as share the best deals and promotions from our advertisers with you. The information below will be used to optimize the content and make ads across the network more relevant to you. You can always change the information you share with us by editing your profile.

By clicking "Create Account", I hearby grant permission to Postmedia to use my account information to create my account.

I also accept and agree to be bound by Postmedia's Terms and Conditions with respect to my use of the Site and I have read and understand Postmedia's Privacy Statement. I consent to the collection, use, maintenance, and disclosure of my information in accordance with the Postmedia's Privacy Policy.